Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 121255-1 | NY |
Y | 2084N0400X | Neurologist | 60115 | GA |
NPI | 1013900919 |
---|---|
Provider Name | Dr. Neil S Lava |
First Address | Atlanta, GA 30329-2206 |
Second Address | Atlanta, GA 30329-2206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2005 |
Last Update Date | 22/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
169085553H | (05) | GA |
B82279 | (02) | NY |